Valvular & structural heart diseaseCohort study
Twenty-Five–Year Follow-Up of Quantified Mitral Regurgitation
- Prospective cohort study
- single-centre
- tertiary referral centre
Authors' conclusion
In this 25-year follow-up cohort study, increasing ERO was associated with an increase in risk of mortality under medical therapy. Patients with upper-moderate MR (ERO 30-39 mm2) at baseline demonstrated a significant association between surgical treatment and improved long-term survival.
Study context
- Population
- Asymptomatic patients with holosystolic degenerative mitral regurgitation (MR), Mayo Clinic, enrolled 1991–2000, followed through May 2025median follow-up 26 years
- Participants
- 449 patients
- Exposure
- Baseline MR severity by ERO categories; surgery vs no surgery
- ERO <20 mm²n = 127reference
- ERO 20-39 mm²n = 128
- ERO ≥40 mm²n = 194
- Outcome
- All-cause mortality by baseline ERO (Cox models adjusted for CV risk factors)
Main finding
Survival under medical therapy · 5 years
Adjusted hazard ratio
2.53
95% CI 1.30–4.93
P = 0.01
By group
Higher ERO (per IQR increase)
adjusted HR 2.53 (95% CI 1.30–4.93); P = 0.01
Per IQR increase, as printed
As reported in the abstract
Observational data: associations, not effects.
Further findings
10-year cumulative incidence of surgery
- 10-year cumulative incidence of surgery — Mitral valve surgery during follow-up
- 254 (57%)
Survival difference, surgery vs no surgery, by ERO
- Survival difference widened with ERO, starting above 30 mm²
- χ23 = 8.4
- interaction P = .04
Original publication
Twenty-Five–Year Follow-Up of Quantified Mitral Regurgitation. JAMA Cardiol. Published 1 September 2026. doi:10.1001/jamacardio.2026.2389
Summarised from the published abstract; every number is checked against it